This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Preterm birth (PTB;37 weeks gestation) and low birthweight (LBW;2,500 g) deliveries continue to increase in the U.S. resulting in substantial economic and societal costs. Adverse pregnancy outcomes are disproportionately expressed in ethnic and racial minority populations and historically underserved populations, particularly from rural regions of the nation. However, a substantial proportion of the general overall increase in incidence of PTB and LBW, including severe PTB (32 weeks) and very low birthweight (1,500 g), cannot be explained by classical risk factors for these negative birth outcomes. Thus, a broader view of the potential interrelationships leading to adverse pregnancy outcomes, including biologic markers or processes could provide some predictive value allowing earlier intervention to reduce this burden in the population. This investigation will test the General Hypothesis that "women who deliver preterm will have higher levels of prenatal inflammatory markers in whole saliva, serum and cervico-vaginal fluid (CVF), which are displayed earlier in pregnancy compared to women who deliver term". Three specific aims will be used to guide the study in testing this hypothesis: Specific Aim 1: To compare and contrast the expression of trimester-specific prenatal inflammatory markers in whole saliva, serum and CVF. Rationale: This aim will determine our ability of detect trimester-specific inflammatory markers in saliva, serum, and CVF. Specific Aim 2: To define the differences in the expression of trimester-specific prenatal inflammatory markers between women who do and do not experience preterm birth in a multi-racial/ethnic population. Rationale: This aim will establish PTB-specific risk factors based on prenatal inflammatory biomarker profiles in a racially/ethnically diverse population of Caucasian, African American and Hispanic/Latino women) and preterm birth (37 completed weeks of gestation). Specific Aim 3: To determine if trimester-specific prenatal inflammatory markers linked with psychosocial and biobehavioral variables pose a significant risk for preterm birth in a multi-racial/ethnic sample of pregnant women. Rationale: This aim will establish if trimester-specific systemic and local prenatal markers of inflammation coupled with psychosocial and biobehavioral variables impact preterm birth risk and self-reported levels of prenatal depressive symptoms;anxiety;stress, urine cotinine, and self-reported prenatal SHS exposure